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Acadia Hospital expanding to treat more kids in crisis

Providers say it's a drop in the bucket as kids languish waiting for mental health services.

MAINE, Maine — There is some positive news on the horizon regarding helping kids access the mental health treatment they desperately need. 

Northern Light Acadia Hospital in Bangor is expanding its facility and adding more beds to its pediatric wing. But some health officials say the nearly $50 million project will need to go further in the face of this growing crisis.

When Acadia Hospital opened its doors more than 30 years ago, it was licensed for 100 inpatient mental health beds. Most are semi-private rooms with two beds each. But since most patients can't share a room, 40 beds for children and adults sit empty.

One of the bottlenecks is that a lot of the children on the waitlist need a private room, and it's needed, according to Dr. John Campbell, the vice president and senior physician at Acadia Hospital.

That picture will change in January when a more than $49 million expansion project is expected to be completed. The facility will still have 100 beds — 50 for adults and 50 for children — but patients will be in their rooms with the privacy Campbell said they deserve.

"Private rooms are a much better experience for the children, the patients, and the staff caring for them," Campbell added.

During a recent tour of Acadia's new pediatric wing, Dwane Albert, the facilities project manager for Northern Light Health, showed us private rooms under construction, plus two different courtyards for children and adolescents.

"The adolescent courtyard will have a reduced-size basketball court and equipment for them," Albert explained. 

Patient rooms for adults will also be remodeled. There will also be group spaces for therapy, art, and other activities. The paint colors, lighting, textures, and layout are designed to be a safe and warm environment to encourage healing.

But Campbell admits the multimillion-dollar expansion is not a long-term solution as the demand for mental health services soars.

"Anything we do will be helpful but not solve the problem. That will continue," Campbell said.

In 2022, according to data from the Maine Department of Health and Human Services, 861 children spent seven days on average in emergency departments waiting for a pediatric mental health bed in the four hospitals that treat children with serious mental health needs — a crisis exacerbated by severe staff shortages overwhelming small rural hospitals like Franklin Memorial Hospital in Rumford.

"We need those beds. I am happy to see that. But we need a lot more," Dr. Ross Isacke, the Franklin Community Health Network chief medical officer, said. 

During the pandemic, the hospital opened an annex next to its emergency department to handle a crush of kids in crisis. While that strain has eased, the hospital continues seeing young patients with severe needs that can't be cared for at home.

"We have kids as young as 6 or even 5, which is terrifying to think we have behavior that can't be managed in the community," Isacke added. 

It's a crisis that is also impacting the state’s largest hospital systems. Northern Light Health operates 10 Central and Northern Maine hospitals, including Eastern Maine Medical Center. In 2022, the average number of kids waiting in emergency rooms systemwide each month was 21. Dr. Michael Melia is the chief of emergency Medicine for EMMC. He said the Acadia Hospital expansion is welcome news but doesn’t go far enough to address the ongoing crisis.

"We need to increase the volume of patients they can care for. They can care for more acute or acuity patients," Melia said.

Maine Health which operates Maine Medical Center and seven emergency departments in its system, reports that some children have languished in their EDs for over eight weeks. Katie Harris is the chief government affairs officer for Maine Health. Harris said from January to June 30 this year, 226 children were stuck in Maine Health Emergency Departments for more than 48 hours. The average length of stay was five and a half days.

"Adolescents come to the emergency room with significant behavioral health issues but for whom hospital-level care is not the right level of treatment," Harris said. 

Earlier this year, lawmakers took up LD 131, a bill that would have required the Maine DHHS to open a secure children's psychiatric residential treatment facility for patients with behavioral health and intellectual and developmental disabilities.

The first of its kind in the state, supporters say a PRTF would be a safe alternative for treating children in a secure residential setting. Due to the lack of capacity, dozens of children are being sent out of Maine for treatment.

"We can bring them home where care is closer to natural support systems and even save the state money," Jayne Van Bramer, the president and CEO of Sweetser, testified before the legislature's Health and Human Services Committee members. 

Sweetser is a behavioral health nonprofit that provides evidence-based treatment, support through a statewide network of community-based mental health, recovery, and educational services. DHHS officials testified against the bill, saying the agency is working to address the crisis. That includes improving reimbursement rates for a potential 20-bed facility for patients who need a higher level of care. Under the proposal, passed by both houses, DHHS must report back in January about the rules it will adopt to set up a pediatric residential treatment facility.

 Maine Behavioral Health Care meanwhile plans to add eight new adolescent beds at Spring Harbor Hospital sometime this fall. 

In a statement, Maine Health spokesperson Caroline Cornish told this to NEWS CENTER Maine: 

We have hired two new child & adolescent psychiatrists (both graduates of the MMC residency program. MBH has partnered with Maine Medical Center’s graduate medical education program to place psychiatry residents in rural areas, working with Pen Bay Medical Center and clinics in Belfast, Rockland, and Damariscotta. There is only one other similar residency program nationwide. On October 1, MBH entered the first year of a SAMHSA implementation grant to focus on access to care for people with serious mental illness and substance use disorders by creating a Certified Community Behavioral Health Clinic (CCBHC) with three locations in York County. A CCBHC is a specially-designated clinic that provides a comprehensive range of mental health and substance use services. CCBHCs serve anyone who walks through the door, regardless of their diagnosis and insurance status. MBH’s substance use disorder programs include 156 Suboxone prescribers serving over 2,000 patients every month. MBH currently serves as the Treatment and Recovery Court provider for ten counties in Maine. This program aims to promote community safety, reduce recidivism and substance use among offenders, and increase the likelihood of successful rehabilitation by implementing a blend of treatment, supervision, appropriate responses, and incentives.

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